Innovative Service Design

Public sector service design & systems thinking

Moving from enforcing to helpingGiving good and supportive help when delivering public services results in confidence and independence

​The BackgroundA local government council in England decided that they wanted to review the way that they tackled community problems like noise, anti-social behaviour, dog fouling, neighbour disputers and rubbish in gardens. These services are always backed by legislation that defines the limits of what is acceptable, and this drives behaviour and the rules.

Due to past experience, the Director had a clear understanding that Service Design was the methodology that he wanted to use. And the staff were placed in a new integrated Hub together with the Police.

The approach that was taken, follows the classic Service Design approach that shares its principles with Design Thinking. In effect, the task was to go through three main stages:

​The Community Safety project team was set up, and the role of the consultant was to develop the Service Design principles with the team, and give the team the right tools when they needed them. The team then undertake the approach, develop the prototype, and design the implementation.

Understand

The team worked for four weeks, understanding how the system worked. We discovered that all the demands could be classified were: my neighbour is noisy, I dont like my neighbours behaviour, there is a car parked on the road for a long time, I am being harassed, and there is lots of rubbish outside someone house.

These are a few examples of what we found in the first two weeks:

The team began to realise that we kept getting repeat calls - what was that about? People just did not seem to listen. But we had to be fair and give the same service to all.

The public seemed to react quite badly when we said that we had the power to fine your and that we are not interested in your overall situation - we have a procedure to follow.

We automatically fined people for throwing some of their rubbish round the corner, behind the hedge. Why not? We had to treat everyone the same. Some people got very annoyed at this, and this puzzled us.

After 4 weeks of investigating, this is what we learned about the service we all had been working in:

There were many people we dealt with that we just did not help.

We spent lots of time on things that added no value

70% of demands were investigated, but never resolved.

​45% of demands were due to neighbour disputes.

75% of the demands were different to what they were documented originally.

60% of people we deal with are recorded on 3 or more separate computer systems.

70% of our demands are linked to housing or the police.

In 85% of all cases examined, the team have discovered that there person is having additional issues from other services – in other words they are complicated.

The team now had hard evidence that how their current procedures worked did not produce a very effective or an efficient service. The team started to realise that there was work to do to improve the service. By this point the team were very enthusiastic to make changes – but were unsure exactly what to do.

The Work – Community SafetyTo understand the process that the council staff take is not straightforward, because there is no typical problem. Imagine a community – anything that annoys anyone in that community is dealt with this group. They called themselves Community Safety. So, to make clear the change that occurred, I have taken one of the simplest examples – to show that it is not the problem itself that is important– how the problem is viewed and resolved that is the key to a better service.

Example - A problem with Rubbish

This is a story of two people John and Sandra, who both have domestic rubbish accumulating in the garden.

John, has accumulated an amount of rubbish on his front garden. And this is the workflow:

Someone in the community complains.

A call taker, follows a standard procedure, records the details on a system. This becomes a task.

The task gets sent to the manager, who after a few days sends it to an officer.

The nominated council officer visits the house, knocks on the door and tries to speak to the person inside. The officer ensures that the person understands that this needs to be cleared and will lead to a fine if the problem is not resolved in a week. But John is at work.

The officer returns to their office and records down the details on the system.

The officer creates an official letter at their computer, completes the IT system details of what they have done, and sends the letter to be posted.

John gets an official letter from the council pushed through his door that states that the rubbish contravenes housing tenancy agreement. It also says that if the rubbish is not moved within a week, a fine will be applied.

John quickly removes the rubbish, he drives it to the local tip. The subsequent visit by the council officer finds that the waste has been removed, and the council has rightly done their job.

Looking at John’s situation; he has recently split from his wife, and has let things get out of hand. He has been away visiting relatives for a week, and just got back to his work. When he got the letter from the officer, he recognised that he needed to tidy the garden up and did that.

Comparing John with Sandra

Sandra has accumulated an amount of rubbish on his front garden. And this is her workflow:

She gets the same visit, and letter. But Sandra has not moved the rubbish within the week. The council officer visits, again and verbally tells Sandra that he now has to fine her. She swears at the officer and slams the door.

The officer, then goes back to the office and writes up the whole scenario on the system. But the officer has been trained to be customer focused, so the officer makes several visits to talk to Sandra in the next weeks – delivering letters when the door is not answered.

Sandra eventually throws the rubbish over the fence, and the officer is not happy about this.

Sandra is fined. But because she cannot afford the fine, the council agrees for her to pay small amounts every week.

The council go and pick up the rubbish.

Looking at Sandra's situation. Sandra, has an uncle, who was released from prison, stay at her house for several weeks. The uncle sometimes invites strange guests in Sandra’s house. One of Sandra’s children is out of control, and she often screams at the child. Sandra is very unhappy, feels alone and unsupported.

Sandra often just cannot cope with the normal things in life that need to be done – it has all got too much. She does what she can to reduce any problems. To cope she tries to live with someone who she thinks has a strong character, and so she tolerates the uncle. Sandra has lived with two other strong men in the last three years, but they have sometimes abused her. Because of the extra people in the house, there is more rubbish than fits in the standard waste bin that Sandra has been given.

Every time Sandra gets a letter from the council it’s a new problem for her. How is she meant to get rid of the rubbish? She does not have a car. So to reduce her daily worry she simply throws all council letters, unopened, in the bin. When she got a letter from the council about her rubbish, she threw it in the bin.

The council approach is to treat every case of rubbish in a garden, the same way. But we are discovering that different people have got very different needs.

Giving John the letter to tidy his garden helped him to keep his life under control.

Giving Sandra the same letter as John, made her life worse. It pushed her level of need just one more step higher than it was. And it may have cleared up some of her garden, but all she did was remove the problem from her sight.

​The Prototype and the New Approach

The team spent several weeks with service design, taking the next cases that came into the council at random, and tried to perform them in a new way. And for each case they compared both approaches by measuring what happened, and estimating what would have happened in the old way of working.

What the team learned after working in the new way:

We can make a big difference to people’s lives, we have to stop making people’s lives worse.

Before doing anything, we need to understand the whole picture about someone; listen, and never judge.

Ignore departmental boundaries as much as possible.

The officer who knows most should make the correct outcome happen.

Take ownership of helping to solve the problem.

Get support from others if you need to, or pass on ownership to someone else if that is the most appropriate action.

The team analysed the root causes of the issues they dealt with, and they were: low level anxiety, depression, childhood issues, personality issues, and chaotic lifestyles due to lifestyle and family issues.

Take each case on its merits and do not follow a standard course of action.

The main activity that was used to help people, was – listen and to give advice.The team did not use a process anymore, they used a framework to help them understand what to do in different situations. This view developed from systems thinking methodology.

Taking the new approach with Sandra - what the officer would do now:

A complaint is made about rubbish in the garden.

The offer who picks up the call, records down the location and then searches the system to find out more about Sandra. The officer finds out that she is behind in her rent payment, and that she has had several dealings with the council for problems.

The officer visits Sandra and asks if he can come inside for a chat – but the officer does not mention the rubbish. The officer asks questions about how Sandra is able to pay the rent, and she talks for 20 minutes to the officer about all the problems she is having.

The officer then asks Sandra if she has a problem with rubbish, she says yes. The officer sees that she needs an extra bin. Then the officer asks how he can help her get rid of the rubbish. Sandra cries – it’s the first offer of help anyone has given her in weeks. They agree that the council will pick up the existing rubbish from the garden. And the officer then goes to his van and gets an extra bin and gives it to her.

Sandra cannot thank the officer enough, she feels better for the rest of the day, and she does not shout at her child so much anymore. She feels more confident, and now has a hope that the council might help her in future, rather than give her more problems.

No recording on the council IT system was required, except for one sentence. Only one visit was needed by the officer.

The outcome was achieved with a significant reduction is actual work for the council. And a far better outcome for Sandra.

Comparing the Two ApproachesIt is difficult to list down the differences between the two approaches, because in this apparent simple situation, the outcomes are complex. But the description of the old and new approach highlights the difference in outcome for Sandra. This was a straightforward problem, most of the demands coming in were more involved than this one.

Another case that the team came across was Tracey - A 22 year old woman complains of anti-social behaviour. The causes of her issues were to do with;

Immaturity about knowing what to do in situations most adults her age would know.

Low level anxiety.

Pressure from her father was distracting her focus.

Outcome – after three visits, her anxiety had reduced, we helped her gain her confidence. She did not need any more support, and she had started to look for work.

The outcome was achieved with a reduction by around 30% in actual work for the council. And a far better outcome for Tracey. She just needed someone to answer her questions, and begin to give her confidence in herself.

If you are interested in the detail of Tracey and her work with us, (8 min audio)

​The Outcome of the TrialThe results recorded in the cases taken in the trial, using the new way of working are:

Visits out of the office are reduced by 50%.

Letters are almost not sent anymore.

Internal communication within the council has increased x4.

Patrols have almost been eliminated, unless that are the desired solution.

Actual cost savings due to reduced activities between 33% - 42%.

Repeat calls dropped to 0%.

The public loved the new approach.

The staff began to enjoy their work – it’s much better than being unpopular.

StructureAdult Social Care, Mental Health and the Police located some of their staff in the new Hub - to take advantage of the integrated way of working. Inappropriate referrals reduced significantly because staff were able to communicate directly with each other face to face.

Team and Management ApproachThe team discovered a radically new way of working. In the old way, they all followed a common process. But in the new way, each officer had to understand decide for themselves what course of action to take. At the start of the process this was very difficult to comprehend, especially for the managers. I had to help them learn new techniques, and they had to gain confidence in their approach and risk.We created a decision-making framework that helped the officers to structure how to make decisions.Each person became part of a self-managing team to some extent.

Managers The managers had to experiment with new approaches that developed team learning, and also they had to understand new ways of managing and keeping control with an empowered and delegated decisions. This was a challenge, as the old ways were disbanded. I helped managers to learn how to evaluate officers. The manager had to release their normal methods of control. Often the managers would go out with newer officers, to observe and learn how officers worked with the principles.

A weekly session was created where everyone would give an overview of their work, learning was shared, and issues were aired.

The behaviour and culture of everyone in the department changed.

from We enforce to We help

Next is a video of an account of the project from a team member, 8 min

End of article

Below is a description of the approach that was used to undertake this transformation. The methodologies includes Design Thinking and Systems Thinking, incorporated into Service Design.

The Service Design Methodology

The approach that this piece of work took combined Design Thinking principles with Service Design and System Thinking. Each 'thinking' is woven into the overall method, so that in one morning, the conversations will always start with what matters to the end user, and incorporate an end to end perspective. We challenged everything.

The Plan was agreed with the client - but they had no experience of this type of approach, so I had show them that a fixed project management approach would be ineffective - it had to be part of the Understand. But what might be interesting to the reader is that this is really about Transformative change. In this type of change, which is a wicked problem; part of the discovery is to find out where we were going to go. I say we, because this involved transforming peoples thinking as well as the service.​The team - Transforming thinking is something that happens when people decide to explore and accept other possibilities. So, the team that went through this had to be officers from the organisation, plus a manager. They had to undergo the journey, and the only way to do that was for them to actually do it themselves. My role as the consultant was as a facilitator, and as a coach. I would give them the right tools at the right time, and they would develop the outcomes. So, no nice clean diagrams from me, they were all generated by the team.The managers - two of the managers were involved for about 1-2 days a week. They had to start by being part of the team, and they had to learn. Slowly over time they started to learn new ways of interacting with the team and allowing officers to come up with the solutions. The manager had to learn how to work with an empowered and self managing team. Whats the role of the manager when the team are self managing?

The main three elements of Service Design

understand

​So, the first thing we did was to listen to demands:

Demand

listen to the demands coming in. The team did this themselves, and after two days they recorded down what they had found from the forms coming in, listening to phone calls, and listening to people coming in.

The demands were categorised according to what they were.

The team recognised that some of the demands were easy, and some seemed very difficult to fix

From a design thinking and service design perspective starting with the outside-in - customer perspective is fundamental. I would like to detail the approach here for this type of service. Which is perhaps different to many of those others encounter. I understand several levels of 'depth'1. The immediate user experience2. The user feeling when interacting.3. Understanding the customer, their immediate expectations and solutions.4. Understanding the main problems the 'customer' is facing in achieving what thew came to me for.5. All of the above, but extended to their current lives - plus the barriers they face, and what they would like me to help them with.

The video above of Tracey will demonstrate this level.

Each level will produce a different action and outcome. In this work it is important to realise that I operate at level 5. So, the initial demand is often not the problem - it is other things that the council officer can help them with.

The example of Tracey in the text above is a good example of this, where the team had to help her with her decision-making, maturity, and anxiety. That has nothing to do with the service that the council traditionally provide!

​Work FlowWe then started to map the flows of the forms that came in to the office. I showed the team how to do this, and they decided how they were going to complete the task. I facilitated and helped them to create flows that were readable.

Value - and waste reductionWe then looked at the flows and decided which of the activities were value and which were not. We did this because we wanted to focus on Value activities when we began the prototyping.Using Lean techniques, what the team found was that only 10% of activities were creating value! And this was the beginning of the realisation that there was much to improve.

Performance - impact on the public Somehow the team had to understand how well they were doing as a service, and the only way is to measure the success of the customers. The team created capability charts of the end to end time that they had to wait before they were housed. The average time was

prototype & trial

The team members were split and had to work in pairs. Their purpose was to learn new approaches and they achieved this by taking demands and try and do them in a new way. They were given a set of principles to follow.The sequence of what they did is described in the article above. What they learned was discussed at the end of each day all together, and recorded on a large matrix on the wall. We used a combination of systems thinking in overall approach so we effectively started the prototype from a blank piece of paper.

After working this way with a few demands, the teams view of what they had to do was radically changing. They realised that byActively listening,- they would get very different information from people they were there to help and from other staff, we found out what really mattered to people.Focus on value - we could cut out huge amounts of overlap with other departments. And we only recorded what we needed to record on IT. Typical Lean techniques.Outcomes - we did what people asked us to do, if it was reasonable. Previously they had done what the council had told them to do as a standard procedure.Solutions - We searched for solutions that we would not normally be involved with, like give advice on how to deal with low level anxiety.Helped them - if we saw that we were going to push their level of need higher, we would use another approach. So, we would reduce the amount of fines we gave out if we thought that the person had a good reason to do what they were doing, and if they had no money.

implement

We worked together on how to implement this with their colleagues. We created a sort of frameworks that helped guide staff on how to behave and how to make decisions. These frameworks were then used by the manager to help coach individual officers to build up their competence and expertise.

Team WorkingThe manager and the staff created a weekly meeting, where officers would each talk about the work they had been doing, and monition issues that they had. The team would learn from this feedback and also help each other share ideas and problem solving. This session also allowed the manager to get a good understanding of what the officers were doing and the challenges they face.

ImplementationThe implementation plan and method was mostly developed but he original team members. They knew their colleagues well, and knew what they went through to develop this approach. The primary technique of developing others followed the approach of going out with an original team member. So the sequence was:

1. Background information about what we learned in the prototype and trial (1/2 day)2. Going out with an experienced team member (mentor) for the day.3. Structured reflection on the day before.4. The newer officer tries out the approach whilst together with the mentor.5. The cycle continues until the new officer is confident and competent.

I left at this point and they and the managers implemented the approach across the whole department.

Service design and systems thinking transforms a public sector service

IntroductionEnforcement services are recognised as those public sector services that are designed around stopping people from doing something; littering, noise, anti social behaviour are good examples.The services are always backed by legislation that defines the limits of what is acceptable, and those in the service often see themselves as having to ‘police’ or defend something.

Typically, for most services this is a warning, then a fine. Interestingly it is often the case that staff wear uniforms of some type.

Below is an example from a Food Safety Team from England, using a service design, Lean and systems thinking approach to challenge their current way of working.

The Details

When looking at food safety if you ask them what their job is, it is to;

enforce food standards on restaurant owners.

They have the ability to fine, or even to take the owner to court, if they think it is appropriate. For the restaurant owner, the experience is never one that they enjoy - the officer suddenly turns up at my door, telling me that I am here to inspect you.

What Used to Happen

A stern officer arrives suddenly in my restaurant.

“Please give me a place I can change my clothes”

I wait, and worry about all the things I have not got right in my kitchen.

The officer comes into my kitchen all dressed in white, with a clip-board. They ignore me, and look into every corner of my kitchen.

They ask me for my staff training records, and I have two new staff who have not done the training.

After 30 minutes, they take me into my office, and they tell me what I am doing wrong.

The inspector did not see what I was dong right, that I have been very busy this week, and that I am trying my best. I hate them, I try and hide things from them.

When the officer arrives, they put on a white outfit, and walk around the kitchen inspecting what they want to see. The restaurant owner just has to watch. And the officer usually has a list of items they expect to see; clean surfaces, training records & certificates, proof of inspections, and so on.

At the end of the visit the officer will go back to their office, and type up a reference document that lists all the items that failed the inspection. Each problem will include sections from the legislation, and a warning of when they should be completed. The tone of the letter is very standard and official - and the wording must be written assuming that the letter might be shown in court.

What They do NowThe same group of officers, after they have transformed their approach, did something very different. Firstly, they realised from a systemic perspective, that their purpose was to:

help restaurants create safe food - not to fulfil a pre-determined list of criteria.

They now first phone me, and ask when it would be a good time to visit.

They arrive, they get changed, and we have a conversation about what issues I am facing. I tell them about the two new staff, and how busy I have been.

They go to the kitchen and simply watch what is going on.

Then, we have a further conversation and they show my staff a few things that they ask about.

The inspectors write down a few points that I should take care of, and ask me if I need any help with them.

Back in the office, there is the biggest change:

Paperwork has reduced by 80%. We only record what we need we need to, and we don’t type formal letters to the restaurants.

We are not interested in the old measures, so we don’t need to record each problem on the measures system.

The number of activities we used to do in an inspection flow was 134, now it is11.

The purpose has changed from checking, to helping people when they need help. Our motivation has gone right up - I enjoy my work.

If a restaurant manager has a problem, they will now call up the inspector and ask them for advice.

​As an enforcement officer, it is now up to me to decide what I do and how I do it, for each situation I find myself in. It is great to be able to put into practice my knowledge, and help people.In the office we have regular sessions, where we discuss what were doing, and what techniques we have learned. If any of us ever need help, all of us are there at the end of the phone - but the most helpful person is my manager.

The Method - Systems thinking and Service DesignThe approach that was used was to take a team of inspectors and the manager through a series of stages of learning and prototyping - they started by understanding what mattered to the restaurant manager. They also mapped out all the activities that they took to complete a visit, it was 134 steps!​They then set about experimenting with a new purpose - to help the managers create safe food. The team realised they had little idea how to actually do that, so they worked with one restaurant, and then another, until they had learned a new set of techniques and approaches that became their new way of working. They discarded those activities that they deemed not necessary.​The ImplicationsThink of those public services that are 'enforcement' - that fine, chase, force people to do certain things. Imagine what would be the implications to the community if those services, instead ofwe enforce became we help??????​The difference was so great, that an article was published by the Chartered Institute of Environmental Health. You can read it here.

Design thinking, Service design and Systems thinking

If you want to know more about the detail of the design and systems thinking methodology used, it is described in this section...

The approach that this piece of work took combined Design Thinking principles with Service Design and System Thinking. Each 'thinking' is woven into the overall method, so that in one morning, the conversations will always start with what matters to the end user, and incorporate an end to end perspective. We challenged everything.

The Plan was agreed with the client - but they already had experience of this type of approach, and they know that they could not rely on a fixed outcome - it had to be part of the Understand. But what might be interesting to the reader is that this is really about Transformative change. In this type of change, which is a wicked problem; part of the discovery is to find out where we were going to go. I say we, because this involved transforming peoples thinking as well as the service.​The team - Transforming thinking is something that happens when people decide to explore and accept other possibilities. So, the team that went through this had to be officers from the organisation, plus a manager. They had to undergo the journey, and the only way to do that was for them to actually do it themselves. My role as the consultant was as a facilitator, and as a coach. I would give them the right tools at the right time, and they would develop the outcomes. So, no nice clean diagrams form me, they were all generated by the team.The managers - two of the managers were involved for about 1-2 days a week. They had to start by being part of the team, and they had to learn. Slowly over time they started to learn new ways of interacting with the team and allowing officers to come up with the solutions. The manager had to learn how to work with an empowered and self managing team. Whats the role of the manager when the team are self managing?

Understand

Understand is the analysis of the current system, its performance and the impact on the customer. The customer being the restaurant owner.

Systems thinking - The start of the process has to be to ask why are we here - our purpose? Design thinking - And then we have to understand HOW we achieve this purpose from an outside in perspective. Then we can truly get the customer experience, fully in our mind. In this case we were not able to do this until the next stage, this is because this work is so complex and deep, that it was only by trying to design a prototype did we truly understand what mattered to the owners of restaurants. The customer journey, in this example, translates into the what matters to the owner. So journey maps were not appropriate.Design thinking - The team spend a few days developing a workflow map, that contained each activity for a typical inspection. This map is only useful if it tells us something. So, we identified the value and waste.

Systems thinking - 8 value steps, and 160 waste steps!!! The team were stunned. I kept this information until we moved to prototyping.Systems thinking - we had to ask ourselves how effective the current system was? The answer was, we didn't know. But we do know that owners do not like to see us, and they try and hide bad practice from us.

Prototype & learning

With a non-transactional workflow, it is not easy to see a new way forward. So, I had to do some work to get the creative juices flowing. These are officers who have had 'enforcement' drummed into them, for years. So...

Design thinking - On day one, the team had to learn to learn; about chefs, their behaviours, and attitudes. So, they had to go to a restaurant kitchen, stand int he corner, and learn. On their return one group said that it was really interesting... A good start. We worked on that.The next day they went out to learn some more. They all went to a burger van, and talked to the owner - asking open questions.Background - This owner had a poor safety record; he had been asked to replace the floor and put in hot water. But had never done this.Learning - they learned that this man worked 7 days a week, sometimes making no money. Exhausted at the end of the day. He cared that his customers remained safe. The team were a little confused as to why we were spending time doing this..? We asked him if we could come tomorrow?Learning - we saw that he was using his spatula for both cooked meats and fresh meat. Not good - but we did not say anything to him. - we were only allowed to learn, not do anything.Design thinking - The teams task was now to learn, but also to experiment with anything that they thought was useful to help create safe food.What we did - the next day, on the way to see him, we bought a spatula. When we arrived, he said hello, and gave him the spatula. Guess what he did - after a pause his eyes moistened. No-one had ever done anything like that before. Especially not a food safety inspector! He transformed into a welcoming, human being. He chatted, opened up, and was very friendly.Learning - we have learned the secret that has been eluding us. We have now understood how to engage with people. This was the first breakthrough.Design thinking - we now wanted to help him understand how poor he was at food preparation. But the team were not allowed to tell him in ther old way, something else had to happen.What we did - the team designed a graph with all the burger van type business on, and the axis showed each of the businesses from good to poor. We coloured in the poor section in red. We turned up to visit him, was as we approached, he came out, and led us to his van. He offered us all a drink. Over a conversation, we asked him; "how well do you make safe food?" the answer was; oh, I a not great but not as bad as most people."We then asked him to point to where he thought he was on the graph. Then we showed him where his business really was. And we said nothing. His eyes started to stare again. We continued a conversation and left. What we did - after a few days, we returned to learn. Again, he came out and led us to his van, he wanted to show us something. He had fitted a new floor, and he had installed hot water!! iThe time, it was the teams turn to have watery eyes. He was so proud! He had done something the inspectors had asked him to do time and time again, over several years.Learning - the second secret the team learned, was that when you listen, and engage with someone, and treat them ike a human, they respond cooperatively.

TEST

Wen the team had got over their 'enforcement' mindset and learned the fundamental principles of a new way of working, they proceeded to develop a new approach using these principles:- understand the owner as a person and the situation they are in.- find ways of helping the owner to see things about their food preparation.- discuss with them ways forward.- learn and apply, learn and apply, learn and apply...

After a few weeks, they had learned a new approach that was working.

The new workflow - I asked the team to create a new workflow, with only the 8 value steps in - no waste.And they got quite close. Letters were ditched, no reports, and no unnecessary recording on IT systems. The result was two visits a day were normal, rather than one.

Systems thinking - the mindset was the key to everything in this work. As they learned, they unlearned. One of the greatest frameworks that created the old 'enforce' mindset, was the legislation. They would use the wording of the legislation to act as their bedrock, and as an the reason to justify their actions and behaviour.I had to show them, by working with the owners, that the legislation had to be used:

as a guide to safe food preparation, not as a prescriptive set of words.​That was tough to do, but it worked. They finally had the courage to stand on their own two feet as people, who could help people create safe food.

implement

Preparation - Everything about what they did before had to be changed. So procedures, IT systems, measures and tools had to be created. Showing others - The task of teaching others, then began, and the team realised that they could not just tell their fellow inspectiors what they had to do, they had to show them and work with them. It took time, lots of time. But it worked. Two members of staff did not like the new way of working, so they decided to leave.

Design thinking and service design

Is this simply replacing the previous corporate message, that replaced the one before that...

Are you ready to put messages asides and make this really work for your organisation?

I sometimes say to organisational leaders - this is like renting offices across the road, hiring staff and starting again. How would you do it differently?

You would hire managers that know whats going on, and know how to motivate and lead delegated teams

The workflows would be designed from scratch to follow what matters for each customer.

Waste would be minimised so that staff know how to focus on value.

Staff would work together in teams, making decisions that optimise the workflow.

The technology would be designed to support your transformed workflow.

Leaders would receive real information that helps them to make smart decisions.

Transformation is exactly this - and it starts with putting the customer at the heart of what we do. And it ends when every part of the organisation is supporting that - not in words, but in actions.

A public sector example

In one organisation the manager said that her staff all listen to the customer - she was passionate about putting the customer first, she knew that as a truth.

A week later, she said

"My staff dont listen to the customer, we dont pay attention to what matters to them, I am so shocked!"

What had happened, the manager has sat listening to a customer for 20 minutes, who was crying most of the time. The manager realised that policies and procedures of the organisation were what were in the mind of her staff when they listened to customers, and these procedures were used to respond to the customers needs. The answers were not what was needed to deal with the problem in hand.

Transformation

It is like starting anew, and looking at the service or operations from a systemic perspective - its easy, but its difficult to do from where the organisation is today.

​In the example above, the managers led and the staff replaced the rigid procedures with a looser framework. It allowed staff flexibility to do what was right for each customer.

The results were:

a drop in recorded cases by two thirds

soaring satisfaction

freed up time to spend longer to do what was right, and fix root cause issues

​It was not difficult, it just needed the right approach

Most organisations say that they listen to their customers, but is that enough? What happens when we listen... We then revert back to an internal perspective. An agile and flexile organisation delegates staff to be flexible within a framework.

Typically those internal perspectives are not about training, they are the:

Interesting to read this article in the guardian that the issues with the NHS are not just about ‘fixing people’ when they are unwell. But that loneliness has a large impact on people well-being, demonstrated in the figures for 50% less life expectancy to those that are lonely.

AnalysisWhen I did some work in the NHS, and we looked at the demand into hospitals and also helping people in the community - going to the GP, or after they have left the hospital. Something about what we were learning about the demand seemed to need further analysis. It is easy to treat different types of demand as common categories - broken leg, diabetes, etc. But when we looked at the time taken to help people get back to a normal life, there was great variation in the resources and time used with the same category.

ComplexityWe discovered that certain people absorbed far more resources, visit their GP, or were admitted to hospital far more than others. These people often had a level of complexity to their situation that was not obviously identified when looking at their records. When we analysed a cohort of patients it was obvious to attribute age to the cause of increasing complexity. But looking at each person in detail we discovered the causes were various. And what was the highest cause of complexity? Loneliness.

It surprised everyone around us, that this was the result of the analysis. And how well had this health trust geared itself up to respond to this problem? Well, apart from having weekly public social gatherings, the problem was not on anyones radar as being important.

What we didWhat we did was to tackle the loneliness head on, taking a cohort of people that were in the health system. The result was that their interaction with the health system went down, in some cases so dramatically, that they stopped seeing anyone in the NHS.

Its how we view our demandPrior to this analysis, the NHS had been looking at demand using categories that they had created and defined each person. However, this is a good example of looking at a complex system, and applying system thinking principles and techniques to its analysis and design. Then the demand is understood outside-in, how people interact with the system, and what matters to them. This simple approach allows an organisation to fundamentally alter their approach to how they deal with people, so that their resourcrs are cut by 30%, and the outcomes are improved. Predefined categories tend to limit our ability to really understand our organisation and the workflow clearly.

Public sector data protection = data sharing

Data sharing, often a major stumbling block to joined-up working in the public sector. How to use a systemic approach to thinking about the problem and delivering a different and far easier solution.

Lets start with a real case study and define the problem that this organisation had.

The ProblemI came across a new data sharing issue in a new Hub we were redesigning recently. In this situation local government Council staff were newly sitting next to and working with the Police. The question was:

How do we now share information between us?

This was a project started to develop the workflows, policies and practice in the Hub. The Police, and Council front line staff were in a multi-disciplinary change team, and the managers were connected to that team.

What the Police DidIf anyone works with the Police you will find that they have a quite different way of making decisions than any other type of organisation. In the situation with the Hub, they made a local decision to share data in the way that supervisors on the ground thought was reasonable. However, when they went and asked their Data Controller, and the Controller replied they could not share any of the data. As simple as that! The Police then spent the rest of the three months in this position - frustrated, but unable to proceed.

The Standard SolutionAs is usual, the purpose has to be defined or understood. It will be defined by managers, and may be defined something like;

we need a set of rules on how to legally share data between us, that protects people and allows us to work together efficiently.

This is the usual approach in most organisations to solve a problem like this. They will ask a consultant with analytical knowledge to look at this as a project and study the data. They also need to be fully aware of the legislation, so they ask the Data Controller and get a copy of the Data Protection Act, and read it in detail.

This consultant then takes the data types from a data analyst, and attempts to categorise the data into the categories that make sense, and that show different levels of risk. They would look at the job roles of all the people involved and attempt to make a judgement as to the data they are required to view and why. And engage with the Data Controller and put all the collected findings on the table.

The outcome will be a report, that will be approved, and then circulated down through the hierarchy - as each manager makes sure that their particular concern or point is contained in the final report. In some cases this step in the process can take many months and the problem is seen as:

the needs of different stakeholders, which must be taken into account.

Staff groups are put on a schedule to listen to their managers tell them what the new rules are.

The Systemic ApproachUnderstandAgain, the first step that has to happen is that the problem has to be understood. This is done by going to where the work is. The change team listen to demands coming into the Hub, by actually listening to the conversations. They have to understand the whole problem and what matters to the person making the demand.

The purpose they define for the sharing of information remains undefined.

Redesign.The next step, after listening to the demand, is to undertake the work - by just doing the work that matters to fix the problem - together with the person.

The DataSo what of the data sharing? Well, the example above is looked at by the team, and the key information that was needed to provide the knowledge required to solve the problem is written down.

The above process is repeated several times, until the team understand enough about the demands and the knowledge. They might do 20 or more demands.

Then the team sit together and analyse what knowledge is needed, and where it is usually held. Interestingly it is quite often held in peoples memories rather than simply in a computer.

The purpose they define for the sharing of information now emerges from the evidence.

The OutcomeThis analysis is then used to define the agreement on the sharing of knowledge. If a manager does not like this, or wants to add other rules, then they have to work with the team to demonstrate that the evidence proves that this change should be made.

The word data is not included in any document or discussion. The purpose of this exercise is the sharing of knowledge

From a systems thinking perspective, what is important in this problem is not about data, but pertinent information regarding a council officer about to visit the property of someone. As soon as you make it data you have entered the world of concepts and ideas. Systems thinking has to be firmly rooted in the reality of what the the system is really about.

The solution was surprisingly easy, focus on the information - not the data. When there is a new demand, and the council officer wants to know about the what we know about the person making the demand, then they ask a police officer in-front of a computer if there are any issues I need to be aware of when I visit Mr. Smith.The officer could respond with;

no problem,

maybe you should go with a colleague,

the mother has difficulties talking to a official,

there may be someone staying there illegally,

talk to Jason, he knows a bit about this family,

a police officer will go with you as it might be tricky,

dont go - lets have a conversation...

After the demands were understood, It took about two weeks to define, and make into a workshop for staff.

The Difference Between Systems Thinking and our Usual Approach?Point 1 - there is are no stakeholder needs, as the person and the demand defines the need.Point 2 - there is no inflexible set of rules that applies to certain categories of demands.Point 3 - the managers do not initially define the outcome, the evidence does. Then the managers agree the analysis the team undertook.

What is needed is not the data, its the knowledge I need before the visit and during the process. This real need by-passes all data arguments, as the real basis of data sharing is the sharing of knowledge. The sharing of data can be a side issue to the main principle, that is often used when sharing is between people far away from each other and who are unable to collaborate. If you can collaborate with your colleague in the other service, then the sharing becomes one of knowledge - and a different and much easier problem to fix.

In addition, this approach supports the front line staff and is flexible to every situation. So no detailed procedures or rules are necessary - just the creation of a set of principles to work to in a framework that front-line staff can be coached to use.

This is an real example of using systems thinking to the problem of data sharing. The problem is redefined from data to knowledge - which is should have always been in the first place, if the legislation had been looked at from a systemic perspective then maybe the problem so many public sector organisations are having would be made alot easier.

The ﻿data protection act﻿ in the UK is actually written to help data sharing and to prevent private organisations from marketing our data. But we tend to see it only as the method of restricting communication. Certainly those who wrote it made a big error in the way that it puts across the central concept of what it is about. But, it really does focus on DATA, and in public sector operations we are far more interested in information.